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Just picture this you are working your shift, the night has been quiet, you are sitting there documenting while talking about your plans for your next day off. Alarms are heard, an announcement goes over the intercom Code Blue with a room number. The halls filled with nurses and techs racing in the direction of the announced room. A patient had stopped breathing. You get to the place, a crowd hovers around the entrance to the doorway. The new nurse spends their time in the group outside the door really not sure what to do or how to help.
#1 Be Ready to do CPR
If you are in the room when it happens or even outside the in the hallway and come in to help, the initial job will be CPR. Points to remember before you start, make sure the bed is in the right position for CPR. Most beds will have a lever to deflate the mattress or a piece of the headboard that can be placed under the patient. This is so during compressions you are able to make appropriate compressions and not pressing the body into the mattress. You will be needed to help switch out so that exhaustion does not occur when only one person is performing CPR. Don’t be a hero if you are becoming tired express this so that you can switch out with someone else. In a hospital setting, there should be a bag valve mask or self-inflating bag that can be used for the breath.
#2 Bring the Crash Cart
On the run over to the room even if you haven’t seen the patient grab the crash cart. Unplug the crash-cart from the wall, you don’t want to grab, go and get caught on the wall. The crash-cart has the essentials for most of the interventions during a code, although on a rare occasion I have seen them grab an intubation cart from ICU. When the code begins getting the crash-cart to the room is essential, the defibrillator applied to the chest in between the compressions will give the patient a higher probability of survival.
#3 Grab a Vital Machine
Some units may have their vitals machines as part of the wall, monitors displayed in the room, showing oxygen, heart rate, blood pressure. I work on a Medical-Surgical floor and only have the vital machines or otherwise known as a nurse on a stick. Once the physicians and the rest of the code team meet at the room one question within the barrage of other important ones will be “what are there vitals?”. The duration of the code you will need to take vitals multiple times until the code ends.
#4 Glucometer
The glucometer is another item missed and forgotten. When a patient is either found unconscious or become unconscious taking the blood sugar. The blood sugar may or may not play a part, but if the blood sugar does play a role, and the patient has a critically low blood sugar. Something so essential can be missed if no one takes a glucometer to the room.
#5 Exit the room if you are not assisting
Finally, once all the supplies are bedside and roles are taken, if you are not fulfilling a function and not needed in the room exit the room. The hospital room is small and housing the number of people necessary for a code and the extra people would overwhelm the room. A few people standing outside the door is just as critical as those inside the room. The people outside the room will be asked to be runners, getting needed items from the storage closet. During an unusually long code, I was once asked to place orders for the patient, diagnostic test and blood.
Codes are filled with adrenaline, and with that can turn a well qualifying person in a stupor and bring out confidence and decisiveness in others. A seasoned nurse or a new nurse don’t forget when running to the code, take a second and grab something on your way. When in code what category do you fall into confident and decisiveness or unsure and in a stupor?
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